메뉴 건너뛰기




Volumn 23, Issue 7, 2007, Pages 498-506

Prevention and treatment of sleep deprivation among emergency physicians

Author keywords

Caffeine; Circadian; Melatonin; Modafinil; Shift schedule; Shift work sleep disorder; Sleep deprivation; Zolpidem

Indexed keywords

CAFFEINE; DEXAMPHETAMINE; MELATONIN; METHYLPHENIDATE; MODAFINIL; ZOLPIDEM TARTRATE;

EID: 34547650655     PISSN: 07495161     EISSN: None     Source Type: Journal    
DOI: 10.1097/01.pec.0000280519.30570.fa     Document Type: Review
Times cited : (15)

References (55)
  • 3
    • 0029086001 scopus 로고
    • The hypothalamic-pituitary- adrenocortical system and sleep in man
    • Friess E, Wiedemann K, Steiger A, et al. The hypothalamic-pituitary- adrenocortical system and sleep in man. Adv Neuroimmunol. 1995;5(2):111-125.
    • (1995) Adv Neuroimmunol , vol.5 , Issue.2 , pp. 111-125
    • Friess, E.1    Wiedemann, K.2    Steiger, A.3
  • 4
    • 0035313943 scopus 로고    scopus 로고
    • Sleep and memory: A molecular perspective
    • Graves L, Pack A, Abel T. Sleep and memory: a molecular perspective. Trends Neurosci. 2001;24(4):237-243.
    • (2001) Trends Neurosci , vol.24 , Issue.4 , pp. 237-243
    • Graves, L.1    Pack, A.2    Abel, T.3
  • 6
    • 0025994664 scopus 로고
    • Effect of a change in house staff work schedule on resource utilization and patient care
    • Gottlieb DJ, Parenti CM, Peterson CA, et al. Effect of a change in house staff work schedule on resource utilization and patient care. Arch Intern Med. 1991;151(10):2065-2070.
    • (1991) Arch Intern Med , vol.151 , Issue.10 , pp. 2065-2070
    • Gottlieb, D.J.1    Parenti, C.M.2    Peterson, C.A.3
  • 7
    • 28544434971 scopus 로고    scopus 로고
    • Too little sleep gradually desensitizes the serotonin 1A receptor system
    • Roman V, Walstra I, Luiten PG, et al. Too little sleep gradually desensitizes the serotonin 1A receptor system. Sleep. 2005;28(12):1505-1510.
    • (2005) Sleep , vol.28 , Issue.12 , pp. 1505-1510
    • Roman, V.1    Walstra, I.2    Luiten, P.G.3
  • 8
    • 0034625822 scopus 로고    scopus 로고
    • Circadian rhythms in a nutshell
    • Edery I. Circadian rhythms in a nutshell. Physiol Genomics. 2000;3(2):59-74.
    • (2000) Physiol Genomics , vol.3 , Issue.2 , pp. 59-74
    • Edery, I.1
  • 9
    • 0035119878 scopus 로고    scopus 로고
    • Fatal accidents following changes in daylight savings time: The American experience
    • Varughese J, Allen RP. Fatal accidents following changes in daylight savings time: the American experience. Sleep Med. 2001;2(1):31-36.
    • (2001) Sleep Med , vol.2 , Issue.1 , pp. 31-36
    • Varughese, J.1    Allen, R.P.2
  • 10
    • 0033044439 scopus 로고    scopus 로고
    • Physician substance use by medical specialty
    • Hughes PH, Storr CL, Brandenburg NA, et al. Physician substance use by medical specialty. J Addict Dis. 1999;18(2):23-37.
    • (1999) J Addict Dis , vol.18 , Issue.2 , pp. 23-37
    • Hughes, P.H.1    Storr, C.L.2    Brandenburg, N.A.3
  • 11
    • 0019723904 scopus 로고
    • Anchor sleep as a synchronizer of rhythms on abnormal routines
    • Minors DS, Waterhouse JM. Anchor sleep as a synchronizer of rhythms on abnormal routines. Int J Chronobiol. 1981;7(3):165-188.
    • (1981) Int J Chronobiol , vol.7 , Issue.3 , pp. 165-188
    • Minors, D.S.1    Waterhouse, J.M.2
  • 12
    • 0020974271 scopus 로고
    • Does 'anchor sleep' entrain circadian rhythms? Evidence from constant routine studies
    • Minors DS, Waterhouse JM. Does 'anchor sleep' entrain circadian rhythms? Evidence from constant routine studies. J Physiol. 1983;345:451-467.
    • (1983) J Physiol , vol.345 , pp. 451-467
    • Minors, D.S.1    Waterhouse, J.M.2
  • 13
    • 27644560608 scopus 로고    scopus 로고
    • Sleep loss and performance in residents and nonphysicians: A meta-analytic examination
    • Philibert I. Sleep loss and performance in residents and nonphysicians: a meta-analytic examination. Sleep. 2005;28(11):1392-1402.
    • (2005) Sleep , vol.28 , Issue.11 , pp. 1392-1402
    • Philibert, I.1
  • 14
    • 0028142505 scopus 로고
    • Predicting mental health problems in general practitioners
    • Chambers R, Belcher J. Predicting mental health problems in general practitioners. Occup Med (Lond). 1994;44(4):212-216.
    • (1994) Occup Med (Lond) , vol.44 , Issue.4 , pp. 212-216
    • Chambers, R.1    Belcher, J.2
  • 15
    • 1642382418 scopus 로고    scopus 로고
    • Fellowship training, workload, fatigue and physical stress: A prospective observational study
    • Parshuram CS, Dhanani S, Kirsh JA, et al. Fellowship training, workload, fatigue and physical stress: a prospective observational study. CMAJ. 2004;170(6):965-970.
    • (2004) CMAJ , vol.170 , Issue.6 , pp. 965-970
    • Parshuram, C.S.1    Dhanani, S.2    Kirsh, J.A.3
  • 16
    • 11844288306 scopus 로고    scopus 로고
    • Extended work shifts and the risk of motor vehicle crashes among interns
    • Barger LK, Cade BE, Ayas NT, et al. Extended work shifts and the risk of motor vehicle crashes among interns. N Engl J Med. 2005;352(2):125-134.
    • (2005) N Engl J Med , vol.352 , Issue.2 , pp. 125-134
    • Barger, L.K.1    Cade, B.E.2    Ayas, N.T.3
  • 18
    • 0030980507 scopus 로고    scopus 로고
    • Doctors' perceptions of the links between stress and lowered clinical care
    • Firth-Cozens J, Greenhalgh J. Doctors' perceptions of the links between stress and lowered clinical care. Soc Sci Med. 1997;44(7):1017-1022.
    • (1997) Soc Sci Med , vol.44 , Issue.7 , pp. 1017-1022
    • Firth-Cozens, J.1    Greenhalgh, J.2
  • 19
    • 0029805616 scopus 로고    scopus 로고
    • Burnout and its correlates in emergency physicians: Four years' experience with a wellness booth
    • Goldberg R, Boss RW, Chan L, et al. Burnout and its correlates in emergency physicians: four years' experience with a wellness booth. Acad Emerg Med. 1996;3(12):1156-1164.
    • (1996) Acad Emerg Med , vol.3 , Issue.12 , pp. 1156-1164
    • Goldberg, R.1    Boss, R.W.2    Chan, L.3
  • 20
    • 0028113704 scopus 로고
    • Relationship of day versus night sleep to physician performance and mood
    • Smith-Coggins R, Rosekind MR, Hurd S, et al. Relationship of day versus night sleep to physician performance and mood. Ann Emerg Med. 1994;24(5):928-934.
    • (1994) Ann Emerg Med , vol.24 , Issue.5 , pp. 928-934
    • Smith-Coggins, R.1    Rosekind, M.R.2    Hurd, S.3
  • 21
    • 0038175510 scopus 로고    scopus 로고
    • The night float paradigm to decrease sleep deprivation: Good solution or a new problem?
    • Cavallo A, Ris MD, Succop P. The night float paradigm to decrease sleep deprivation: good solution or a new problem? Ergonomics. 2003;46(7):653-663.
    • (2003) Ergonomics , vol.46 , Issue.7 , pp. 653-663
    • Cavallo, A.1    Ris, M.D.2    Succop, P.3
  • 22
    • 0035220540 scopus 로고    scopus 로고
    • The impact of fatigue in air medical and other types of operations: A review of fatigue facts and potential countermeasures
    • Caldwell JA. The impact of fatigue in air medical and other types of operations: a review of fatigue facts and potential countermeasures. Air Med J. 2001;20(1):25-32.
    • (2001) Air Med J , vol.20 , Issue.1 , pp. 25-32
    • Caldwell, J.A.1
  • 23
    • 0035880319 scopus 로고    scopus 로고
    • Innovative working schedule: Introducing one short nap during the night shift
    • Bonnefond A, Muzet A, Winter-Dill AS, et al. Innovative working schedule: introducing one short nap during the night shift. Ergonomics. 2001;44(10):937-945.
    • (2001) Ergonomics , vol.44 , Issue.10 , pp. 937-945
    • Bonnefond, A.1    Muzet, A.2    Winter-Dill, A.S.3
  • 24
    • 0027765235 scopus 로고
    • Effects of 24-hour shift work with nighttime napping on circadian rhythm characteristics in ambulance personnel
    • Motohashi Y, Takano T. Effects of 24-hour shift work with nighttime napping on circadian rhythm characteristics in ambulance personnel. Chronobiol Int. 1993;10(6):461-470.
    • (1993) Chronobiol Int , vol.10 , Issue.6 , pp. 461-470
    • Motohashi, Y.1    Takano, T.2
  • 25
    • 33749673573 scopus 로고    scopus 로고
    • Improving alertness and performance in emergency department physicians and nurses: The use of planned naps
    • 596-604. 604 e1-e3
    • Smith-Coggins R, Howard SK, Mac DT, et al. Improving alertness and performance in emergency department physicians and nurses: the use of planned naps. Ann Emerg Med. 2006;48(5):596-604. 604 e1-e3.
    • (2006) Ann Emerg Med , vol.48 , Issue.5
    • Smith-Coggins, R.1    Howard, S.K.2    Mac, D.T.3
  • 26
    • 13844308951 scopus 로고    scopus 로고
    • The nighttime nap strategies for improving night shift work in workplace
    • Takeyama H, Kubo T, Itani T. The nighttime nap strategies for improving night shift work in workplace. Ind Health. 2005;43(1):24-29.
    • (2005) Ind Health , vol.43 , Issue.1 , pp. 24-29
    • Takeyama, H.1    Kubo, T.2    Itani, T.3
  • 27
    • 33748460270 scopus 로고    scopus 로고
    • The pharmacology of wakefulness
    • Miller DB, O'Callaghan JP. The pharmacology of wakefulness. Metabolism. 2006;55(10 suppl 2):S13-S19.
    • (2006) Metabolism , vol.55 , Issue.10 SUPPL. 2
    • Miller, D.B.1    O'Callaghan, J.P.2
  • 28
    • 0033672844 scopus 로고    scopus 로고
    • A taurine and caffeine-containing drink stimulates cognitive performance and well-being
    • Seidl R, Peyrl A, Nicham R, et al. A taurine and caffeine-containing drink stimulates cognitive performance and well-being. Amino Acids. 2000;19(3-4):635-642.
    • (2000) Amino Acids , vol.19 , Issue.3-4 , pp. 635-642
    • Seidl, R.1    Peyrl, A.2    Nicham, R.3
  • 29
    • 33644770260 scopus 로고    scopus 로고
    • Adenosine receptors as therapeutic targets
    • Jacobson KA, Gao ZG. Adenosine receptors as therapeutic targets. Nat Rev Drug Discov. 2006;5(3):247-264.
    • (2006) Nat Rev Drug Discov , vol.5 , Issue.3 , pp. 247-264
    • Jacobson, K.A.1    Gao, Z.G.2
  • 30
    • 3542995692 scopus 로고    scopus 로고
    • Low-dose repeated caffeine administration for circadian-phase-dependent performance degradation during extended wakefulness
    • Wyatt JK, Cajochen C, Ritz-De Cecco A, et al. Low-dose repeated caffeine administration for circadian-phase-dependent performance degradation during extended wakefulness. Sleep. 2004;27(3):374-381.
    • (2004) Sleep , vol.27 , Issue.3 , pp. 374-381
    • Wyatt, J.K.1    Cajochen, C.2    Ritz-De Cecco, A.3
  • 31
    • 33646708788 scopus 로고    scopus 로고
    • Cortisol responses to mental stress, exercise, and meals following caffeine intake in men and women
    • Lovallo WR, Farag NH, Vincent AS, et al. Cortisol responses to mental stress, exercise, and meals following caffeine intake in men and women. Pharmacol Biochem Behav. 2006;83(3):441-447.
    • (2006) Pharmacol Biochem Behav , vol.83 , Issue.3 , pp. 441-447
    • Lovallo, W.R.1    Farag, N.H.2    Vincent, A.S.3
  • 32
    • 0023026702 scopus 로고
    • States of anxiety and their induction by drugs
    • Lader M, Bruce M. States of anxiety and their induction by drugs. Br J Clin Pharmacol. 1986;22(3):251-261.
    • (1986) Br J Clin Pharmacol , vol.22 , Issue.3 , pp. 251-261
    • Lader, M.1    Bruce, M.2
  • 33
    • 33947193022 scopus 로고    scopus 로고
    • Effects of caffeine are more marked on daytime recovery sleep than on nocturnal sleep
    • Carrier J, Fernandez-Bolanos M, Robillard R, et al. Effects of caffeine are more marked on daytime recovery sleep than on nocturnal sleep. Neuropsychopharmacology. 2007;32:964-972.
    • (2007) Neuropsychopharmacology , vol.32 , pp. 964-972
    • Carrier, J.1    Fernandez-Bolanos, M.2    Robillard, R.3
  • 34
    • 12944331944 scopus 로고    scopus 로고
    • Caffeine effects on recovery sleep following 27 h total sleep deprivation
    • LaJambe CM, Kamimori GH, Belenky G, et al. Caffeine effects on recovery sleep following 27 h total sleep deprivation. Aviat Space Environ Med. 2005;76(2):108-113.
    • (2005) Aviat Space Environ Med , vol.76 , Issue.2 , pp. 108-113
    • LaJambe, C.M.1    Kamimori, G.H.2    Belenky, G.3
  • 35
    • 0344193511 scopus 로고    scopus 로고
    • Distinctive effects of modafinil and d-amphetamine on the homeostatic and circadian modulation of the human waking EEG
    • Chapotot F, Pigeau R, Canini F, et al. Distinctive effects of modafinil and d-amphetamine on the homeostatic and circadian modulation of the human waking EEG. Psychopharmacology (Berl). 2003;166(2):127-138.
    • (2003) Psychopharmacology (Berl) , vol.166 , Issue.2 , pp. 127-138
    • Chapotot, F.1    Pigeau, R.2    Canini, F.3
  • 36
    • 0038240433 scopus 로고    scopus 로고
    • Modafinil maintains waking in the fruit fly drosophila melanogaster
    • Hendricks JC, Kirk D, Panckeri K, et al. Modafinil maintains waking in the fruit fly drosophila melanogaster. Sleep. 2003;26(2):139-146.
    • (2003) Sleep , vol.26 , Issue.2 , pp. 139-146
    • Hendricks, J.C.1    Kirk, D.2    Panckeri, K.3
  • 37
    • 31544471840 scopus 로고    scopus 로고
    • Cognitive performance following modafinil versus placebo in sleep-deprived emergency physicians: A double-blind randomized crossover study
    • Gill M, Haerich P, Westcott K, et al. Cognitive performance following modafinil versus placebo in sleep-deprived emergency physicians: a double-blind randomized crossover study. Acad Emerg Med. 2006;13(2):158-165.
    • (2006) Acad Emerg Med , vol.13 , Issue.2 , pp. 158-165
    • Gill, M.1    Haerich, P.2    Westcott, K.3
  • 38
    • 33750134851 scopus 로고    scopus 로고
    • Cognitive performance during sustained wakefulness: A low dose of caffeine is equally effective as modafinil in alleviating the nocturnal decline
    • Dagan Y, Doljansky JT. Cognitive performance during sustained wakefulness: a low dose of caffeine is equally effective as modafinil in alleviating the nocturnal decline. Chronobiol Int. 2006;23(5):973-983.
    • (2006) Chronobiol Int , vol.23 , Issue.5 , pp. 973-983
    • Dagan, Y.1    Doljansky, J.T.2
  • 39
    • 4344665010 scopus 로고    scopus 로고
    • Modafinil's effects on simulator performance and mood in pilots during 37 h without sleep
    • Caldwell JA, Caldwell JL, Smith JK, et al. Modafinil's effects on simulator performance and mood in pilots during 37 h without sleep. Aviat Space Environ Med. 2004;75(9):777-784.
    • (2004) Aviat Space Environ Med , vol.75 , Issue.9 , pp. 777-784
    • Caldwell, J.A.1    Caldwell, J.L.2    Smith, J.K.3
  • 40
    • 0031873467 scopus 로고    scopus 로고
    • Effect of modafinil on plasma melatonin, cortisol and growth hormone rhythms, rectal temperature and performance in healthy subjects during a 36 h sleep deprivation
    • Brun J, Chamba G, Khalfallah Y, et al. Effect of modafinil on plasma melatonin, cortisol and growth hormone rhythms, rectal temperature and performance in healthy subjects during a 36 h sleep deprivation. J Sleep Res. 1998;7(2):105-114.
    • (1998) J Sleep Res , vol.7 , Issue.2 , pp. 105-114
    • Brun, J.1    Chamba, G.2    Khalfallah, Y.3
  • 41
    • 15444368645 scopus 로고    scopus 로고
    • Does modafinil enhance cognitive performance in young volunteers who are not sleep-deprived?
    • Randall DC, Viswanath A, Bharania P, et al. Does modafinil enhance cognitive performance in young volunteers who are not sleep-deprived? J Clin Psychopharmacol. 2005;25(2):175-179.
    • (2005) J Clin Psychopharmacol , vol.25 , Issue.2 , pp. 175-179
    • Randall, D.C.1    Viswanath, A.2    Bharania, P.3
  • 42
    • 0030755899 scopus 로고    scopus 로고
    • Self-monitoring cognitive performance during sleep deprivation: Effects of modafinil, d-amphetamine and placebo
    • Baranski JV, Pigeau RA. Self-monitoring cognitive performance during sleep deprivation: effects of modafinil, d-amphetamine and placebo. J Sleep Res. 1997;6(2):84-91.
    • (1997) J Sleep Res , vol.6 , Issue.2 , pp. 84-91
    • Baranski, J.V.1    Pigeau, R.A.2
  • 43
    • 26444522583 scopus 로고    scopus 로고
    • A case of premature ventricular contractions with modafinil
    • Oskooilar N. A case of premature ventricular contractions with modafinil. Am J Psychiatry. 2005;162(10):1983-1984.
    • (2005) Am J Psychiatry , vol.162 , Issue.10 , pp. 1983-1984
    • Oskooilar, N.1
  • 44
    • 22044443131 scopus 로고    scopus 로고
    • Combined effects of methamphetamine and zolpidem on performance and mood during simulated night shift work
    • Hart CL, Haney M, Nasser J, et al. Combined effects of methamphetamine and zolpidem on performance and mood during simulated night shift work. Pharmacol Biochem Behav. 2005;81(3):559-568.
    • (2005) Pharmacol Biochem Behav , vol.81 , Issue.3 , pp. 559-568
    • Hart, C.L.1    Haney, M.2    Nasser, J.3
  • 45
    • 0033621813 scopus 로고    scopus 로고
    • Efficacy of Dexedrine for maintaining aviator performance during 64 hours of sustained wakefulness: A simulator study
    • Caldwell JA, Smythe NK, Leduc PA, et al. Efficacy of Dexedrine for maintaining aviator performance during 64 hours of sustained wakefulness: a simulator study. Aviat Space Environ Med. 2000;71(1):7-18.
    • (2000) Aviat Space Environ Med , vol.71 , Issue.1 , pp. 7-18
    • Caldwell, J.A.1    Smythe, N.K.2    Leduc, P.A.3
  • 46
    • 33747193808 scopus 로고    scopus 로고
    • Prevalence, correlates, and comorbidity of nonmedical prescription drug use and drug use disorders in the United States: Results of the National Epidemiologic Survey on Alcohol and Related Conditions
    • Huang B, Dawson DA, Stinson FS, et al. Prevalence, correlates, and comorbidity of nonmedical prescription drug use and drug use disorders in the United States: Results of the National Epidemiologic Survey on Alcohol and Related Conditions. J Clin Psychiatry. 2006;67(7):1062-1073.
    • (2006) J Clin Psychiatry , vol.67 , Issue.7 , pp. 1062-1073
    • Huang, B.1    Dawson, D.A.2    Stinson, F.S.3
  • 47
    • 33646709935 scopus 로고    scopus 로고
    • Melatonin and human rhythms
    • Arendt J. Melatonin and human rhythms. Chronobiol Int. 2006;23(1-2):21-37.
    • (2006) Chronobiol Int , vol.23 , Issue.1-2 , pp. 21-37
    • Arendt, J.1
  • 48
    • 11844250002 scopus 로고    scopus 로고
    • Melatonin as a hypnotic: Pro
    • Zhdanova IV. Melatonin as a hypnotic: pro. Sleep Med Rev. 2005;9(1):51-65.
    • (2005) Sleep Med Rev , vol.9 , Issue.1 , pp. 51-65
    • Zhdanova, I.V.1
  • 49
    • 7044269602 scopus 로고    scopus 로고
    • Melatonin improves sleep in asthma: A randomized, double-blind, placebo-controlled study
    • Campos FL, da Silva-Junior FP, de Bruin VM, et al. Melatonin improves sleep in asthma: a randomized, double-blind, placebo-controlled study. Am J Respir Crit Care Med. 2004;170(9):947-951.
    • (2004) Am J Respir Crit Care Med , vol.170 , Issue.9 , pp. 947-951
    • Campos, F.L.1    da Silva-Junior, F.P.2    de Bruin, V.M.3
  • 50
    • 0036051470 scopus 로고    scopus 로고
    • Herxheimer A, Petrie KJ. Melatonin for the prevention and treatment of jet lag. Cochrane Database Syst Rev. 2002;2:CD0015200.
    • Herxheimer A, Petrie KJ. Melatonin for the prevention and treatment of jet lag. Cochrane Database Syst Rev. 2002;2:CD0015200.
  • 51
    • 20744455245 scopus 로고    scopus 로고
    • Melatonin treatment of pediatric residents for adaptation to night shift work
    • Cavallo A, Ris MD, Succop P, et al. Melatonin treatment of pediatric residents for adaptation to night shift work. Ambul Pediatr. 2005;5(3):172-177.
    • (2005) Ambul Pediatr , vol.5 , Issue.3 , pp. 172-177
    • Cavallo, A.1    Ris, M.D.2    Succop, P.3
  • 52
    • 0031825797 scopus 로고    scopus 로고
    • Can melatonin improve adaptation to night shift?
    • James M, Tremea MO, Jones JS, et al. Can melatonin improve adaptation to night shift? Am J Emerg Med. 1998;16(4):367-370.
    • (1998) Am J Emerg Med , vol.16 , Issue.4 , pp. 367-370
    • James, M.1    Tremea, M.O.2    Jones, J.S.3
  • 53
    • 33746373526 scopus 로고    scopus 로고
    • Sleep disorders, sleepiness and traffic safety: A public health menace
    • Pandi-Perumal SR, Verster JC, Kayumov L, et al. Sleep disorders, sleepiness and traffic safety: a public health menace. Braz J Med Biol Res. 2006;39(7):863-871.
    • (2006) Braz J Med Biol Res , vol.39 , Issue.7 , pp. 863-871
    • Pandi-Perumal, S.R.1    Verster, J.C.2    Kayumov, L.3
  • 54
    • 21644442480 scopus 로고    scopus 로고
    • Fatigue in military aviation: An overview of US military-approved pharmacological countermeasures
    • Caldwell JA, Caldwell JL. Fatigue in military aviation: an overview of US military-approved pharmacological countermeasures. Aviat Space Environ Med. 2005;76(7 suppl):C39-C51.
    • (2005) Aviat Space Environ Med , vol.76 , Issue.7 SUPPL.
    • Caldwell, J.A.1    Caldwell, J.L.2
  • 55
    • 0242637204 scopus 로고    scopus 로고
    • Zolpidem-related effects on performance and mood during simulated night-shift work
    • Hart CL, Ward AS, Haney M, et al. Zolpidem-related effects on performance and mood during simulated night-shift work. Exp Clin Psychopharmacol. 2003;11(4):259-268.
    • (2003) Exp Clin Psychopharmacol , vol.11 , Issue.4 , pp. 259-268
    • Hart, C.L.1    Ward, A.S.2    Haney, M.3


* 이 정보는 Elsevier사의 SCOPUS DB에서 KISTI가 분석하여 추출한 것입니다.